Current pharmacological modalities for management of novel coronavirus disease 2019 (COVID-19) and the rationale for their utilization: A review.

SARS-CoV-2 has caused a pandemic which is putting strain on the health-care system and global economy. There is much pressure to develop both preventative and curative therapies for SARS-CoV-2 as there is no evidence to support therapies to improve outcomes in patients with SARS-CoV-2. Medications that inhibit certain steps of virus life cycle that are currently used to treat other illnesses such as Malaria, Ebola, HIV and Hepatitis C are being studied for use against SARS-CoV-2. To date, data is limited for medications that facilitate clinical improvement of COVID-19 infections.

Prevalence and predictors of positive screening for postpartum depression in minority parturients in the South Bronx.

It is reported that the rates of perinatal depressive disorders are high in ethnic minority groups from non-English speaking countries. However, very few studies have compared the prevalence of positive screening for postpartum depression (PPD) in minority communities living in an inner city. The goal of this study is to determine the prevalence and the predictors of positive screening for postpartum depression in minority parturients in the South Bronx. The study is a chart review of 314 minority parturients, Black or Hispanic, screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) tool. The overall prevalence of a positive EPDS screen among Black and Hispanic women was similar, 24.04 and 18.75%, respectively. The Black immigrant cohort had comparable positive screens with 23.81 as African Americans. Hispanic women born in the USA had the least prevalence of positive screens, 7.14%, and those who moved from the Dominican Republic and Puerto Rico had a prevalence of 17.24% of positive screens. The women who immigrated from Mexico, Central America, or South America had the highest prevalence of positive screens for PPD, 32.26%. As to the socioeconomic status (SES), there was a significant increase of 27.04 vs. 13.95% (P < 0.019) in positive screens for PPD for the unemployed mothers. Overall, Black and Hispanic parturients had similar rates of positive screens for PPD. Among the Hispanic women, immigrants had higher rates of positive screens, with those from Mexico, Central, and South America as the highest. The hospital experience did not affect the rates of positive screens. Neither did the SES with one exception; those unemployed had the higher rates of positive screens.

Primum non nocere: how active management became modus operandi for intrahepatic cholestasis of pregnancy.

The Royal College of Obstetrics and Gynecology does not endorse routine active management of intrahepatic cholestasis of pregnancy (ICP)-affected pregnancies. In contrast, the American College of Obstetricians and Gynecologists supports active management protocols for ICP. To investigate this controversy, we evaluated the evidence supporting ICP as a medical indication for early term delivery and the evolution of active management protocols for ICP. Sixteen articles published between 1986 and 2011 were identified. We created 2 groups based on whether obstetric care included active management. Group 1 comprised 6 uncontrolled reports without active management that were published between 1967 and 1983 that described high perinatal mortality rates that primarily were related to prematurity sequel. This group became the fundamental 'core' evidence for ICP-associated stillbirths and by extrapolation justification for active management. Group 2 was comprised of 10 reports in which the authors credited empirically adopted active management with the observed low stillbirth rates in ICP-affected pregnancies. Although the group 1 articles routinely are cited as evidence of ICP-associated stillbirth risk, the 1.2% stillbirth rate (4/331) in this group is similar to the background stillbirth rates of 1.1% (11/1000) and 0.6% (6/1000) in 1967 and 2011, respectively (P = .062 and P = .0614, respectively). Likewise, the stillbirth rates for articles in group 2 were similar to their respective national stillbirth rate. Nevertheless, group 2 articles have become the evidence-based support for active management. We found no evidence to support the practice of active management for ICP.

In-Flow Generation of Thionyl Fluoride (SOF2) Enables the Rapid and Efficient Synthesis of Acyl Fluorides from Carboxylic Acids.

Herein, we report an approach for generating thionyl fluoride (SOF2) from the commodity chemicals thionyl chloride (SOCl2) and potassium fluoride (KF). The methodology relies on a microfluidic device that can efficiently produce and dose this toxic gaseous reagent under extremely mild and safe conditions. Subsequently, the in situ-generated thionyl fluoride is reacted with an array of structurally and electronically differing carboxylic acids, leading to the direct and efficient synthesis of highly sought-after acyl fluorides. Importantly, our investigation also highlights the inherent modularity of this flow-based platform. We demonstrate the adaptability of this approach by not only synthesizing acyl fluorides but also directly converting carboxylic acids into a diverse array of valuable compounds such as esters, thioesters, amides, and ketones. This versatility showcases the potential of this approach for a wide range of synthetic applications, underscoring its significance in the realm of chemical synthesis.

Centers for Disease Control and Prevention-Recognized Diabetes Prevention Program After Gestational Diabetes Mellitus.

Gestational diabetes mellitus is associated with an increased risk of developing type 2 diabetes mellitus. To decrease or delay the risk of developing type 2 diabetes mellitus after gestational diabetes mellitus, postpartum care should include a recommendation that the individual participates in a recognized Diabetes Prevention Program.

Short interpregnancy interval and misoprostol as additive risks for uterine rupture: a case report.

BACKGROUND: Short interpregnancy interval and uterine instrumentation are risk factors for uterine rupture in subsequent pregnancies. Misoprostol as a uterotonic agent is an additive risk factor for rupture of a scarred uterus. CASE: Misoprostol induction for a term stillbirth was complicated by uterine rupture. Risk factors for this uterine rupture might have included interpregnancy intervals of < 7 months, prior uterine instrumentation, and misoprostol as a uterotonic agent. CONCLUSION: Caution and a high index of suspicion are warranted when using misoprostol as a uterotonic agent after a short interpregnancy interval.

A retrospective review of glargine use in pregnancy.

OBJECTIVE: To review the obstetric outcome of 240 diabetic pregnancies maintained on basal glargine insulin. STUDY DESIGN: This is a retrospective review of the medical data from 240 pregnant diabetics who received glargine as a basal insulin. Perinatal outcome was abstracted from August 29, 2001, to December 31, 2007. RESULTS: Mean maternal age was 33 years (SD +/- 5). Seventy-seven percent (184 of 240) of the women were diagnosed with gestational diabetes. The remaining 23% (56 of 240) had a diagnosis of type 2 diabetes. Weekly evaluation of each woman's daily 7x/d fingersticks yielded an individual mean capillary glucose value. These individual mean capillary glucose values were used to calculate a mean value for our sample population. This overall mean capillary glucose value for the 240 parturients was 112 +/- 14.8 mg/dL. The mean neonatal birth weight was 3,142 +/- 606 g. Only 4 neonates had birth weights > 4,000 g (4,365, 4,384, 4,535 and 4,624). None of the neonates were hypoglycemic. CONCLUSION: Prenatal glargine appears to be well tolerated with acceptable perinatal outcome. For well-controlled pregestational diabetics, consideration should be given to continuing glargine during pregnancy.

Synchronous Choriocarcinoma and Epithelioid Trophoblastic Tumor Concurring at the Cesarean Scar: A Case Report and Review of the Literature.

We present a complicated case of recurrence of gestational trophoblastic neoplasms (GTN), mixed ETT and choriocarcinoma at an abdominal cesarean scar. This tumor consisted of typical morphologic and immunophenotypic features of ETT and choriocarcinoma. The tumor recurred despite the patient undergoing chemotherapy. The patient had this abdominal mass resected three times. The elements of ETT and coexisting choriocarcinoma varied each time. Due to re-recurrence of the tumor, the following decisions had been made: total abdominal hysterectomy, bilateral salpingectomy, right-sided inguinal lymph node biopsy. At the time of this report, recurrence was negative.

Laparoscopic Vessel Endometriosis Resection Surgery: A Case Report and Review of Literature.

BACKGROUND: Endometriosis usually occurs in the pelvis and often involves the ovaries, the uterosacral and broad ligaments, and the pelvic peritoneum. In rare instances, it can occur in the vasculature of the pelvis. Patients with endometriosis present with abnormal pain, menstrual cycle disruption and infertility. Management of endometriosis is usually surgical with excision of the tissue via laparoscopic means. CASE: A 42-year-old Gravida 5, Para 2-0-3-2 patient with a 22 year history of endometriosis, who had had multiple laparoscopic endometriosis resections, total abdominal hysterectomy, and an exploratory laparotomy with bilateral salpingo-oophorectomy, presented with left pelvic pain when standing, dyspareunia, and a 3.7 cm cyst on ultrasound. The patient underwent laparoscopic vessel endometriosis resection and excision of endometriotic nodules from external iliac vessels. Final pathology report showed evidence of old endometriosis in all locations. On interval follow-up, the patient reported sustained relief from pain. CONCLUSION: Complete resection of endometriosis from large vessels can be successfully achieved laparoscopically by a well-experienced surgeon with delicate, proper techniques.

Reactivity and properties of bis(chlorodifluoroacetyl) peroxide generated in situ from chlorodifluoroacetic anhydride for chlorodifluoromethylation reactions.

We developed a practical chlorodifluoromethylation reaction mediated by diacyl peroxide generated in situ from chlorodifluoroacetic anhydride. Allylic and amino-chlorodifluoromethylations of alkenes proceeded well with the combination of this reagent, Cu(ii) catalyst and a pyridine additive. Carbo- and aromatic chlorodifluoromethylations proceeded under metal-free conditions.